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Abdominoplasty (Tummy Tuck) After Massive Weight Loss

Dramatic weight loss has many health benefits. If you've recently undergone (or are currently undergoing) a weight loss journey, congrats!

Unfortunately, after any substantial amount of weight loss - whether due to weight loss surgery or lifestyle changes, many people find that their skin and tissues lack the elasticity to conform to their newly reduced body size.

Luckily, there is a surgical option to remove the excess skin and fat and repair problematic muscle tissues. An abdominoplasty after massive weight loss is a surgical procedure designed to remove the excess skin and other concerns commonly seen in weight loss patients.


Obesity changes the quality and dynamics of abdominal wall tissues, fat, and skin. As we gain weight, our skin stretches, stretch marks form, and our abdominal muscles weaken. Increased fat in the intra-abdominal area leads to a separation of muscles in the midline, which can be especially pronounced in women who have experienced pregnancy.

Weight loss decreases the amount of fat in the your body, especially within the subcutaneous layer. If you lose a considerable amount of weight, your skin might remain stretched and sagging even after you've lost the weight.

If the weight loss is more rapid than gradual (like in patients who have undergone a weight loss surgery), you might end up with skin that stretches and hangs over your abdominal area.

It is also not uncommon to see abdominal hernias in patients who have undergone significant weight loss - either within previous abdominal incision sites or even spontaneously.

And of course, as we lose weight - it doesn't always happen evenly. Some patients lose fat in the abdomen but not the hips or thighs (pear shape) - others lose fat in the arms and legs but struggle to lose weight in the abdominal area.

Each of these considerations demand an individualized approach to the abdominal contouring of a patient who experienced massive weight loss.


Like with most other post-bariatric body contouring procedures, a good candidate for the surgery is:

  • In reasonably good health
  • Has some established weight loss
  • Has realistic expectations and a positive outlook
  • Is not a smoker

The presence of scars from previous surgeries may limit some options. The procedure should also be postponed if an active infection is present. 

If you smoke, you will be asked to quit smoking two months prior to treatment as well as during recovery to reduce risk of bleeding. If you do not follow these instructions, your surgery will be cancelled for your safety.


During the procedure, patients are placed under anesthesia for their comfort and safety. A fully tummy tuck requires a horizontal incision in the area between the pubic hairline and belly button. The shape and length of the incision will depend on the amount of excess skin to be removed. A second incision might be necessarily to remove excess skin in the upper abdomen.


Once the abdominal skin is lifted, the underlying weakened abdominal muscles are repaired. 


Once all excess skin and fat have been removed and muscles have been repaired, the incisions are closed and recovery begins.



Tummy tuck recovery typically lasts several weeks. 

During your tummy tuck recovery, dressings or bandages may be applied to your incisions, and you may be wrapped in an elastic bandage or a compression garment to minimize swelling and support your abdomen as it heals following surgery.

Small, thin tubes may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing.

You will be given specific instructions that include:

  • How to care for the surgical site and drains
  • Medications to apply or take orally to aid healing and reduce the potential for infection
  • Specific concerns to look for at the surgical site or in your general health
  • When to come in for your follow-up appointments

Make sure that both you and whoever might be assisting you understand your care instructions and ask any questions you may have. This will ensure a quick and smooth recovery.


A tummy tuck does involve a larger incision - sometimes two. With proper scar care, scars will usually fade as much as they will after about one year. It is important to begin scar care as soon as the wound closes to ensure the scars fade as much as possible.

Dr. Majewski will provide his recommendation for a scar gel that will encourage your scars to heal quickly. As with all scars, keep your scar out of direct sunlight. Always apply sunscreen if your scar will be exposed to sunlight - the SkinMedica Essential Defense Mineral Shield Broad Spectrum SPF 35 formula is specifically formulated for post-procedure sun protection. 


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